Disabilities

Bill Provides Relief for Mentally Ill in Legal Limbo

A bill revived from last year’s session would keep defendants with mental health problems from bouncing between state psychiatric hospitals and county jails while waiting to be tried.

An earlier edition of this story was originally published on April 19, 2012, and has been updated with new information and interviews.

By Rose Hoban

In 2007, Floyd Lee Brown was released from Dorothea Dix Hospital after being confined there for 14 years, charged with a crime he was never tried for, after signing a questionable confession. Brown languished at Dix because he was intellectually disabled, with an IQ in the low 50s.

Because of his disability, the district attorney and the prosecutor agreed that Brown’s limited intellectual capacities rendered him “incapable of proceeding” to trial. So he sat in Dix for 14 years.

Image courtesy Donkey Hotey, flickr creative commons

Now a bill to revise North Carolina’s laws to reduce the number of people, like Brown, who get stuck between the mental health system and the criminal system without their cases being resolved is making its way through the legislature.

“I saw these people becoming trapped in these revolving doors that there was no way out of,” said Sen. Shirley Randleman (R-WIlkesboro), who retired from 34 years as the Clerk of Superior Court in Wilkes County before being elected to the General Assembly in 2008.

Randleman convened a committee to work on the problem last year, when she was still in the House of Representatives. Now that she’s in the Senate, she’s revived the bill with essentially the same language, and it’s moving earlier, and faster.

The bill made it through the House on a unanimous vote last year, but not in time to make it through the Senate and to the governor’s desk before the session ended in July, Randleman said.

“Someone is suspected of committing a crime, they’re incarcerated, their ‘capacity’ is questioned, the court orders them to Central Regional Hospital for evaluation, Central Regional finds them incapable to proceed, and then they go back to the jail, then the judge sends them to the state hospital, they get medicated, then they do another capacity hearing, they go back to Central Regional, they go back to the county jail,” Randleman explained in an interview.

Often, Randleman said, defendants end up spending more time incarcerated than if they were convicted and sentenced, “Yet at the same time, there’s no closure for the victims.”

“There could be and should be an expedited process that eliminates the revolving door and provides justice for all,” Randleman said. That’s why she pushed for creating the Incapacity to Proceed Committee, which worked through last year’s session, and then revived the bill which passed the Senate last week and was sent to the House.

Better communication, more training

Sheriffs have complained of the time and money they need to spend to take someone to Central Regional Hospital in Butner, which replaced Dix and the former John Umstead Hospital in 2008. Sheriffs often travel from faraway counties, said Eddie Caldwell, executive vice president and general counsel for the North Carolina Sheriffs’ Association. One of the recommended changes to the law would create a system for certifying forensic evaluators who could be more widely distributed around the state, not just located at the state hospital in Butner, 45 minutes north of Raleigh.

Sen. Shirley Randleman started working on the problem of incapacity to proceed last year when she was still in the House of Representatives.

Another recommendation is to have forensic evaluators located in each county to evaluate people who commit lower-level felonies and misdemeanors, negating the costs of transporting defendants altogether.

“It requires a re-evaluation for capacity to proceed when they’re discharged from the state hospital. And upon release from the state hospital, it does expedite the trial process to avoid deterioration of the defendant while they’re sitting in jail,” Randleman said.

“If we can get them back to the counties where the crime was committed and get them to court before their mental health status deteriorates, we can give them a day in court,” she said.

“The cost of dealing with [these defendants] is very high. So anything that can be done to make the process more efficient while being fair is important to creating efficiencies,” Caldwell said.

Further recommendations from the committee include getting more training for judges, attorneys and prosecutors on recognizing signs of mental illness and developmental disabilities in defendants and the possibility of mandating crisis intervention training for all law-enforcement officers in the state.

Randleman said it’s not just sheriffs who support the bill, but representatives from all parts of the legal and mental health systems.

“We had sheriffs, district attorneys, judges, people from the attorney general’s office, from Central Prison,” Randleman said. “We also had people from the psychiatric community, we had victims’ advocates, defendants’ advocates. We tried to include everyone we could think of when the study was approved.”

Randleman said it was surprisingly easy to find consensus, in part because the bill focuses in on one area of the law that many have acknowledged needs fixing.

No more Floyd Lee Browns

“There’s a lot of fear around this issue,” said Corye Dunn, a policy analyst for Disability Rights North Carolina. Many, if not most, of the people who get trapped in the system because of a mental illness or an intellectual disability have not committed violent crimes.

“I think people have this vision that people with mental health disabilities are violent,” Dunn said, “but we’re talking the full breadth of criminal charges. That’s everything from shoplifting up through felony murder.”

Dunn said that, for example, someone with an intellectual disability could commit a crime that has a maximum 9-month sentence and end up sitting in a forensic mental health unit for far longer. The law, as currently written, gives a judge the option to dismiss charges if a defendant has served time in excess of what his sentence might have been.

That didn’t happen in Floyd Lee Brown’s case. After he had been in Dix Hospital for 10 years, his attorneys filed for a dismissal of his charges. The judge refused.

One of the committee’s proposed changes would compel a judge to dismiss charges in a situation like Brown’s.

“We’re talking about a lot of people not necessarily charged with violent crimes, whose lives are effectively destroyed by this kind of commitment,” said Dunn. She explained that while incarcerated, people can lose homes, jobs and opportunities for placements in treatment programs.

More places for forensic evaluations

The committee also wants the General Assembly to look deeper into the possibility of creating more forensic units around the state that could focus on evaluation and on helping people with intellectual disabilities function better. That would take more money dedicated to the Department of Health and Human Services, something welcomed by advocates.

“We do need a separate forensic unit for people with intellectual disabilities so that they don’t get overwhelmed,” said Julia Adams, lobbyist for the ARC, an organization that works with people with developmental disabilities.

“The statute as it stands now has more language that reflects mental illness,” Adams said. She explained that most of the laws around capacity to proceed focus on treating someone with a mental illness so that they can eventually go to trial.

But for people with serious intellectual disabilities, like Floyd Lee Brown, that may never be possible.

“The needs for our population are more long term,” Adams said.

Adams and others who worked on the committee all said they were pleased with the process and the variety of viewpoints represented.

“There was a good deal of learning going on … and some real compromises taking place,” said Disability Rights’ Dunn.

“When all the discussions were going on, every perspective that could be out there on this issue was represented, listened to and considered,” said Caldwell from the Sheriffs’ Association.

Dunn, Caldwell and others expressed a similar concern that people with mental health problems receive due process while they’re in the criminal justice system.

“Everyone understands the impact of determining that someone can or can’t go to trial,” said Caldwell. “That raises issues of if they’re not capable, and we can’t hold them in jail and we let them out, and they go out and hurt someone, what have we done then?”

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[…] North Carolina Health News: Bill Provides Relief For Mentally Ill In Legal Limbo A bill revived from last year’s session would keep defendants with mental health problems from bouncing between state psychiatric hospitals and county jails while waiting to be tried (Hoban, 3/11). […]